<html>
<body>
<form action="#" method="post">
<fieldset>
<legend>Sign Up Form</legend>
<label for="name">Name</label><br />
<input name="name" id="name" type="text" /><br />
<label for="password">Password</label><br />
<input name="password" id="password"
type="password" /><br /><br />
<label>
<input type="radio" name="loc" />
I'm on my computer
</label><br />
<label>
<input type="radio" name="loc" checked="checked" />
I'm on a shared computer
</label><br /><br />
<input type="submit" value="Log In" /><br />
<label>
<input type="checkbox" name="notify"  />
Keep me signed in on this computer
</label><br />
</fieldset>
</form>
</body>
</html>